Difference between revisions of "Astrocytoma"

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=Common=
=Common=
==Pilocytic astrocytoma==
==Pilocytic astrocytoma==
* Benign, cystic, infratentorial.
* Classic childhood tumor, surgically resectable.
* Variant: [[Pilomyxoid astrocytoma]]
{{Main|Pilocytic astrocytoma}}
{{Main|Pilocytic astrocytoma}}


==Diffuse astrocytoma==
==Diffuse astrocytoma==
* Grade II and III diffuse astrocytic tumors
* Grade II astrocytic tumors typically seen in adults.
* Many of them carry IDH1/2 mutations
* Usually show progression to glioblastoma.
{{Main|Diffuse astrocytoma}}
 
==Anaplastic astrocytoma==
* Grade III astrocytic tumors typically seen in adults.
* Lacks endothelial proliferations and necrosis of glioblastoma.
{{Main|Anaplastic astrocytoma}}


==Glioblastoma==
==Glioblastoma==
* Most common malignant brain tumor peaking around 65 years.
* Prognosis very poor.
* Variant: [[Giant cell glioblastoma]]
* Variant: [[Gliosarcoma]]
{{Main|Glioblastoma}}
{{Main|Glioblastoma}}


=Uncommon=
=Uncommon=
==Subependymal giant cell astrocytoma==
==Subependymal giant cell astrocytoma==
* Intraventricular benign tumor of adolescents.
* Assoicated with [[Tuberous sclerosis]].
{{Main|Subependymal giant cell astrocytoma}}
{{Main|Subependymal giant cell astrocytoma}}


==Pleomorphic xanthroastrocytoma==
==Pleomorphic xanthroastrocytoma (PXA)==
*Abbreviated ''PXA''.
* Kids & young adults usually with good prognosis.
===General===
* Large lipidized cells mimicking a malignant tumor
*Kids & young adults.
{{Main|Pleomorphic xanthoastrocytoma}}
*Prognosis usu. good.
 
===Microscopic===
Features:
*Large cells with intracytoplasmic lipid accumulation, i.e. foamy cytoplasm - '''key features'''.<ref>URL: [http://moon.ouhsc.edu/kfung/jty1/neurotest/Q14-Ans.htm http://moon.ouhsc.edu/kfung/jty1/neurotest/Q14-Ans.htm]. Accessed on: 13 January 2011.</ref>
**May not be obvious/one may have to search for this.
*Focal marked nuclear atypia - including hyperchromasia, marked nuclear enlargement, irregular chromatin.
*Multinucleation - common.
 
Images:
*[http://commons.wikimedia.org/wiki/File:Pleo_xantho.jpg PXA (WC/AFIP)].
*[http://moon.ouhsc.edu/kfung/jty1/neurotest/Q14-Ans.htm PXA (ouhsc.edu)].
 
===IHC===
Features:<Ref>URL: [http://www.pathconsultddx.com/pathCon/diagnosis?pii=S1559-8675%2806%2970469-7 http://www.pathconsultddx.com/pathCon/diagnosis?pii=S1559-8675%2806%2970469-7]. Accessed on: 13 January 2011.</ref>
*GFAP +ve -- required for Dx, may be patchy.
*S-100 +ve -- cytoplasm, usu. diffuse.


==Gliomatosis cerebri==
==Gliomatosis cerebri==
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* More than 3 lobes have to be involved, us. bilateral (radiology).
* More than 3 lobes have to be involved, us. bilateral (radiology).
* biologic behaviour corresponds to WHO III (ICD-O: 9381/3)
* biologic behaviour corresponds to WHO III (ICD-O: 9381/3)


==H3.3 K27M mutated glioma of the midline==
==H3.3 K27M mutated glioma of the midline==
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====Images====  
====Images====  
<gallery>
<gallery>
Image:Gliosarcoma_Histopathology_200x_EVG.jpg | Gliosarcoma - elastic von Giesson. (WC)
Image:Gliosarcoma_Histopathology_200x_EVG.jpg | Gliosarcoma - elastica van Giesson. (WC)
</gallery>
</gallery>
www:
www:
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*SMA +ve.
*SMA +ve.
*Factor VIII +ve.
*Factor VIII +ve.
==Gliofibroma==
* Very rare indolent tumor in children <ref>{{Cite journal  | last1 = Deb | first1 = P. | last2 = Sarkar | first2 = C. | last3 = Garg | first3 = A. | last4 = Singh | first4 = VP. | last5 = Kale | first5 = SS. | last6 = Sharma | first6 = MC. | title = Intracranial gliofibroma mimicking a meningioma: a case report and review of literature. | journal = Clin Neurol Neurosurg | volume = 108 | issue = 2 | pages = 178-86 | month = Feb | year = 2006 | doi = 10.1016/j.clineuro.2004.11.021 | PMID = 16412839 }}</ref>
* Usually not dura-based (DD: Desmoplastic infantile astrocytoma)
* Glial tumor with non-neoplastic fibromatous component.


=See also=
=See also=
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